Prospective randomized double-blind pilot study of site-specific consensus atlas implementation for rectal cancer target volume delineation in the cooperative group setting.
Prospective randomized double-blind pilot study of site-specific consensus atlas implementation for rectal cancer target volume delineation in the cooperative group setting.
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DOI：
10.1016/j.ijrobp.2009.11.012
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发表时间：
2011-02-01
影响因子：
7
通讯作者：
Kachnic, Lisa A.
中科院分区：
文献类型：
--
作者：
Fuller, Clifton D.;Nijkamp, Jasper;Duppen, Joop C.;Rasch, Coen R. N.;Thomas, Charles R., Jr.;Wang, Samuel J.;Okunieff, Paul;Jones, William E., III;Baseman, Daniel;Patel, Shilpen;Demandante, Carlo G. N.;Harris, Anna M.;Smith, Benjamin D.;Katz, Alan W.;McGann, Camille;Harper, Jennifer L.;Chang, Daniel T.;Smalley, Stephen;Marshall, David T.;Goodman, Karyn A.;Papanikolaou, Niko;Kachnic, Lisa A.
靶体积描绘的变化是临床试验中涉及适形放疗的一个重大障碍。我们试图确定共识指南为基础的视觉地图集对目标体积轮廓的影响。由14名医师观察员和一名参考专家绘制了一个代表性病例和靶体积描绘说明，该说明来自一项拟议的直肠癌临床试验，涉及适形放疗。绘制总肿瘤体积（GTV）和2个临床靶体积（CTVA，包括髂内、骶前和直肠周围淋巴结，CTVB，髂外淋巴结）。观察者被随机分配到接受(Group_A) /未接受（Group_B）肛肠癌共识指南和图谱，然后指示重新轮廓相同的病例/图像（Scan2）。使用构象数（CN，其中CN=1等于完全一致）对观察者变异进行体积分析。在14个可评估的轮廓集（1个专家，7个Group_A， 6个Group_B）中，GTV（平均CN为0.75）比ctv（平均CN为0.46-0.65）的一致性更大。Group_A的Atlas暴露导致CTVA的观察者间一致性显著增加（平均初始CN为0.68，图谱后0.76,p=0.03），以及与专家参考的一致性增加（初始平均CN为0.58，图谱后0.69,p=0.02）。对于GTV和CTVB，在地图集暴露后，观察者之间和专家之间的一致意见都没有改变。共识指南图谱的实施导致观察者间协议的可检测差异和CTVA专家体积的更大近似值，但在特定情况下，GTV或CTVB没有。在未来的适形放疗临床试验中，应将视神经图谱纳入考虑。
Variation in target volume delineation represents a significant hurdle in clinical trials involving conformal radiotherapy. We sought to determine the impact of a consensus guideline-based visual atlas on contouring of target volumes. A representative case and target volume delineation instructions derived from a proposed rectal cancer clinical trial involving conformal radiotherapy were contoured (Scan1) by 14 physician observers and a reference expert. Gross tumor volume (GTV), and 2 clinical target volumes (CTVA, comprising internal iliac, pre-sacral, and peri-rectal nodes, and CTVB, external iliac nodes) were contoured. Observers were randomly assigned to receipt (Group_A) /non-receipt (Group_B) of a consensus guideline and atlas for anorectal cancers, then instructed to re-contour the same case/images (Scan2). Observer variation was analyzed volumetrically using conformation number (CN, where CN=1 equals a total agreement). In 14 evaluable contour sets (1 expert, 7 Group_A, 6 Group_B), there was greater agreement for GTV (mean CN 0.75) than CTVs (mean CN 0.46–0.65). Atlas exposure for Group_A led to a significant increased inter-observer agreement for CTVA (mean initial CN 0.68, post-atlas 0.76; p=0.03), as well as increased agreement with the expert reference (initial mean CN 0.58, 0.69 post-atlas; p=0.02). For GTV and CTVB, neither inter-observer nor expert agreement was altered after atlas exposure. Consensus guideline atlas implementation resulted in a detectable difference in inter-observer agreement and greater approximation of expert volumes for CTVA, but not GTV or CTVB, in the specified case. Visual atlas inclusion should be considered as a feature in future clinical trials incorporating conformal radiotherapy.
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影响因子：
5.7
作者：
Grégoire, V;Levendag, P;Reychler, H
通讯作者：
Reychler, H
影响因子：
5.7
作者：
Nijkamp, Jasper;de Jong, Rianne;Marijnen, Corrie
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Marijnen, Corrie
DOI：
10.1016/j.ijrobp.2008.08.070
发表时间：
2009-07-01
影响因子：
7
作者：
Myerson, Robert J.;Garofalo, Michael C.;El Naqa, Issam;Abrams, Ross A.;Apte, Aditya;Bosch, Walter R.;Das, Prajnan;Gunderson, Leonard L.;Hong, Theodore S.;Kim, J. J. John;Willett, Christopher G.;Kachnic, Lisa A.
通讯作者：
Kachnic, Lisa A.
DOI：
10.1016/j.ijrobp.2004.12.089
发表时间：
2005-07-01
影响因子：
7
作者：
Ciernik, IF;Huser, M;Szekely, G
通讯作者：
Szekely, G
影响因子：
5.7
作者：
Senan, S;de Koste, JV;Lagerwaard, FJ
通讯作者：
Lagerwaard, FJ